Toxicity of cancer therapy: what the cardiologist needs to know about angiogenesis inhibitors

Heart
Stephen J H DobbinNinian N Lang

Abstract

Clinical outcomes for patients with a wide range of malignancies have improved substantially over the last two decades. Tyrosine kinase inhibitors (TKIs) are potent signalling cascade inhibitors and have been responsible for significant advances in cancer therapy. By inhibiting vascular endothelial growth factor receptor (VEGFR)-mediated tumour blood vessel growth, VEGFR-TKIs have become a mainstay of treatment for a number of solid malignancies. However, the incidence of VEGFR-TKI-associated cardiovascular toxicity is substantial and previously under-recognised. Almost all patients have an acute rise in blood pressure, and the majority develop hypertension. They are associated with the development of left ventricular systolic dysfunction (LVSD), heart failure and myocardial ischaemia and can have effects on myocardial repolarisation. Attention should be given to rigorous baseline assessment of patients prior to commencing VEGFR-TKIs, with careful consideration of baseline cardiovascular risk factors. Baseline blood pressure measurement, ECG and cardiac imaging should be performed routinely. Hypertension management currently follows national guidelines, but there may be a future role forendothelin-1 antagonism in the prevention...Continue Reading

References

Dec 4, 2002·Nature Reviews. Drug Discovery·Giuseppe RemuzziAriela Benigni
Jan 12, 2007·The New England Journal of Medicine·Bernard EscudierUNKNOWN TARGET Study Group
Dec 18, 2007·Lancet·Tammy F ChuMing Hui Chen
Aug 12, 2009·Journal of Pain & Palliative Care Pharmacotherapy·UNKNOWN National Institute of Neurological Disorders, National Institutes of Health
Jan 9, 2010·Clinical Journal of the American Society of Nephrology : CJASN·Emily S RobinsonBenjamin D Humphreys
Feb 2, 2010·Journal of the American College of Cardiology·Daniela CardinaleCarlo M Cipolla
Mar 31, 2010·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Toni K ChoueiriJoaquim Bellmunt
Mar 31, 2010·Journal of the National Cancer Institute·Michael L MaitlandUNKNOWN Cardiovascular Toxicities Panel, Convened by the Angiogenesis Task Force of the National Cancer Institute Investigational Dr
Dec 1, 2010·Annals of Oncology : Official Journal of the European Society for Medical Oncology·F A B SchutzT K Choueiri
Apr 30, 2011·Journal of the National Cancer Institute·Brian I RiniRobert J Motzer
Nov 18, 2011·Targeted Oncology·Camille TlemsaniFrançois Goldwasser
Jul 13, 2012·American Journal of Hypertension·Nilka de Jesus-GonzalezBenjamin D Humphreys
Dec 6, 2012·Journal of Clinical Pharmacy and Therapeutics·G AsaithambiR A Taylor
Apr 27, 2013·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·Rashmi R ShahDevron R Shah
Aug 24, 2013·The New England Journal of Medicine·Robert J MotzerToni K Choueiri
Aug 31, 2013·Circulation Research·Bonnie KyJavid J Moslehi
Aug 26, 2014·Trends in Cardiovascular Medicine·Joerg Herrmann, Amir Lerman
Sep 7, 2014·Mayo Clinic Proceedings·Joerg HerrmannManish Kohli
Dec 17, 2014·Current Opinion in Pharmacology·Stephanie LankhorstAnton H van den Meiracker
Jan 13, 2015·Critical Reviews in Oncology/hematology·Pooja GhataliaGuru Sonpavde
Mar 6, 2015·British Journal of Cancer·J S L KlothR H J Mathijssen
Mar 15, 2015·Circulation Research·Luuk Te RietA H Jan Danser
May 15, 2015·Clinical Cancer Research : an Official Journal of the American Association for Cancer Research·Naomi B HaasRobert S DiPaola
Sep 1, 2013·EJC Supplements : EJC : Official Journal of EORTC, European Organization for Research and Treatment of Cancer ... [et Al.]·Manuela Schmidinger
May 18, 2016·Journal of Cardiovascular Medicine·Nicola MaureaGiuseppe Mercuro
Jul 28, 2016·Nature Reviews. Molecular Cell Biology·Michael SimonsLena Claesson-Welsh
Oct 13, 2016·The New England Journal of Medicine·Javid J Moslehi
Oct 19, 2016·Journal of Cardiovascular Medicine·Nicola MaureaGiuseppe Mercuro
Feb 16, 2017·Clinical Cancer Research : an Official Journal of the American Association for Cancer Research·Vivek NarayanBonnie Ky
Sep 4, 2017·The Journal of Clinical Hypertension·Haythem GuigaGabrielle Sarlon-Bartoli

❮ Previous
Next ❯

Citations

Dec 14, 2018·Heart·Catherine M Otto
Sep 30, 2020·Clinical Science·Karla B NevesRhian M Touyz
May 15, 2020·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Tienush RassafUNKNOWN Committee for Clinical Cardiovascular Medicine of the German Cardiac Society
Jan 31, 2020·Frontiers in Cardiovascular Medicine·Sherry-Ann Brown
Jan 11, 2020·Deutsches Ärzteblatt International·Katja SchlichtigMartin F Fromm
Mar 23, 2021·Expert Opinion on Drug Safety·Remo PotoGilda Varricchi
Apr 2, 2021·Circulation Research·Daan C H van DorstNinian N Lang
May 1, 2021·Journal of Clinical Medicine·Michał BohdanEwa Lewicka
May 6, 2021·Journal of Cardiovascular Pharmacology·Tongtong YangLiansheng Wang
Mar 20, 2021·Cardiovascular Research·Andrea CignarellaMatthias Barton
Aug 14, 2021·ESC Heart Failure·Moritake IguchiUNKNOWN PREHOSP-CHF Study Investigators
Sep 24, 2019·JACC. CardioOncology·Rhian M Touyz, Ninian N Lang
Oct 9, 2021·Current Pharmaceutical Design·Bing LvXiao-Liang Liu

❮ Previous
Next ❯

Related Concepts

Related Feeds

Angiogenesis Inhibitors to Treat Cancer

Cancer treatments including angiogenesis inhibitors prevent tumor cells from receiving nutrients and oxygen. Here is the latest research on angiogenesis inhibitors for the treatment of cancer.

Cardiotoxicity

Cardiotoxicity refers to the muscle damage or dysfunction of heart electrophysiology caused by drug intake or due to disease complications. It is a well-known side effect of several cytotoxic drugs, especially of the anthracyclines and can lead to long term morbidity. Here is the latest research.

Cardiovascular Disease Pathophysiology

Cardiovascular disease involves several different processes that contribute to the pathological mechanism, including hyperglycemia, inflammation, atherosclerosis, hypertension and more. Vasculature stability plays a critical role in the development of the disease. Discover the latest research on cardiovascular disease pathophysiology here.

Cardiomyopathy

Cardiomyopathy is a disease of the heart muscle, that can lead to muscular or electrical dysfunction of the heart. It is often an irreversible disease that is associated with a poor prognosis. There are different causes and classifications of cardiomyopathies. Here are the latest discoveries pertaining to this disease.